Comparison of Uptake and Outcome of Opportunistic versus Routine Pap test in a Tertiary Hospital in Enugu, Nigeria

Abstract

Background: Cervical cancer is a common female cancer in sub‑Saharan Africa and the second most common cancer affecting women in
Nigeria. This study sought to access the trend and extent of uptake and outcomes of routine versus opportunistic cervical cancer  screening at the pioneer teaching hospital in South-Eastern Nigeria.

Materials and Methods: The study was a retrospective cross-sectional study of all the women that had Pap test at the cervical screening  centre of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria, from January 1, 2013, to December 31, 2017. Data were  obtained from records in the cervical screening unit/centre and morbid anatomy department. Data analysis was done using the Statistical Package for the Social Science (SPSS) version 20.

Results: The mean age of women who had the Pap test was 45 ± 11.2 years(range = 16–86 years). Forty‑five (3.5%) women had abnormal  Pap test results. Amajority (37.8%) of the abnormal Pap test result were low-grade squamous intraepithelial lesion (LSIL), whereas 15.6%  were high-grade squamous intraepithelial lesions. In all, 20.0% of women had features suggestive of invasive carcinoma of the cervix. The  Pap test indication was predominantly opportunistic (66.4%) than routine (33.6%). The prevalence of abnormal Pap tests was  significantly higher in women whose screening was opportunistic than those whose screening was routine (P = 0.024). 

Conclusion: The prevalence of abnormal Pap tests at the UNTH, Enugu, was low, and the most common abnormality was LSIL. Pap test  uptake at the hospital was predominantly opportunistic. The strengthening of the provider-initiated cervical cancer counselling and  testing at the hospital will offer every eligible woman the opportunity for a cervical cancer screening in her lifetime.